Study highlights unique challenges of psoriatic arthritis (PsA)

There are increasingly more effective treatments for psoriatic arthritis (PsA), but the disease has been greatly neglected due to a prior lack of effective therapies and insufficient understanding of the disease’s true impact.

“It has been a disease falling between the chairs of rheumatology and dermatology,” says Lars Erik Kristensen, an internal medicine and rheumatology specialist. “There are a lot of unmet needs in psoriatic arthritis, and we decided to comprehensively study these.”

PsA is a complex disease that involves many organ systems, which makes it unique compared to other diseases, says Dr. Kristensen, chief scientific officer at the University of Copenhagen’s Parker Institute and an associate professor of rheumatology at Lund University in Sweden.

Dr. Kristensen and colleagues published “Societal costs and patients’ experience of health inequities before and after diagnosis of psoriatic arthritis: A Danish cohort study” in Annals of the Rheumatic Diseases.

The study examined 10,525 psoriatic arthritis Danish patients from 1998 to 2014, and 20,777 members of the general public. It sought to better understand the costs PsA poses to patients in terms of their healthcare, employment status, and comorbidities (the presence simultaneously of multiple diseases).

PsA patients, the study found, had more cardiovascular, respiratory, and infectious diseases than the controls. Their healthcare costs were higher and their incomes lower, and overall, their social cost was €10,641 more annually, overall, than it was for those without PsA. They also were likelier to be on disability pensions five years prior to diagnosis of PsA and at the time of diagnosis, as well as a decade later.

“The results of our study are highly suggestive of significant consequences for PsA patients compared to the general population,” Dr. Kristensen says. “Patients or relatives with psoriasis of the skin and concomitant musculoskeletal complaints should not hesitate to contact healthcare providers to raise their concerns and receive appropriate care.”

Dr. Kristensen hopes his and his colleagues’ research will increase awareness of the population of patients with psoriatic arthritis. “They clearly have been under-treated and neglected,” he says.

Although the study focused on patients in Denmark, Dr. Kristensen thinks the results are generalizable to other countries. “I’ve been practicing rheumatology in Norway and Sweden as well, and I see the same patterns,” he says.